The Department of Vascular surgery was founded at the inception of modern vascular surgery in the mid-1950s. It is a department within Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute, which is comprised of Vascular Surgery, Cardiac Surgery, Cardiology and Vascular Medicine. The Department of Vascular Surgery, led by Chairman Daniel Clair, MD, has earned an international reputation for excellence in patient care, surgical results and clinical research.
Much of our experience is in reoperative surgery for patients whose original operations were performed elsewhere. The department serves as a major referral center for these and other complex cases throughout Ohio and the surrounding states of Michigan, New York, Pennsylvania and West Virginia. The large clinical volume promotes an atmosphere of innovation and dedication to patient care. In addition, it allows for the maintenance of multiple training opportunities and provides the basis for providing cutting-edge operative, clinical and vascular laboratory experience.
Cleveland Clinic’s Department of Vascular Surgery provides a variety of training opportunities in vascular surgery. These include:
- Fellowship (5+2) in Vascular Surgery
- Integrated Residency (0+5) in Vascular Surgery
- Aortic Fellowship
- Endovascular Fellowship
- Research Fellowship
As a high-volume tertiary hospital, we have the necessary capacity, faculty support and clinical volume to support these programs. In addition, we have a dedicated faculty that is highly involved in education and research. While each of these programs is distinct, there is cross-education among them. Trainees are part of patient-care teams or disease-specific teams and they work cross-functionally with many healthcare providers to learn and provide patient care. In addition, the Department of Vascular Surgery is dedicated to providing vascular surgery training to our colleagues in General Surgery. This mutual relationship gives Vascular Surgery trainees the opportunity to receive expert training in General Surgery as well.
The training experience at Cleveland Clinic is designed to provide a broad range of exposure, including academic practice, community based practice and VA-based practice. To achieve this, residents and fellows will rotate through several hospitals during their tenure in addition to Cleveland Clinic’s main campus (where the bulk of time is spent). Training takes place at the following locations:
Cleveland Clinic's Vascular Surgery Fellowship is a program dedicated to providing trainees who have completed a five-year general surgery residency the opportunity to qualify for advanced credentials in vascular and endovascular surgery. As one of the largest vascular surgery programs in the country, this unique training is offered at several healthcare settings. This allows for experience with a diverse faculty and a breadth of vascular patients. Fellows participating in this program are trained in both complex open surgical procedures and innovative endovascular therapies.
In addition to the main campus, the training takes place in a variety of facilities, including two Cleveland Clinic community hospitals, Hillcrest and Marymount, as well as the local Veteran’s Hospital and a large outpatient based dialysis center. This complements the training and assures exposure and experience with many patient populations and care settings.
Assignments at Cleveland Clinic’s main campus are with one of several services, with a focus on a specific area of vascular disease. The rotations are typically two-month blocks that move fellows through a variety of services. These services consist of teams of fellows, residents, interns and mid-level providers along with several faculty members. Fellows will typically operate, attend clinics and help manage the service (along with junior residents and mid-level providers) with the faculty on the service to which they are assigned. Daily walking rounds are performed by the team and rounding staff.
Goals and objectives are provided for each rotation, and evaluations occur throughout and at the completion of each rotation. In addition to clinical rotations with Vascular Surgery services, fellows are given research and elective time to pursue clinical and research interests. A Vascular Lab and Medicine rotation, for instance, allows for hands-on learning of vascular lab reading and non-operative patient management. This vascular lab experience can help in fulfilling the RVPI requirements.
Fellows also have an endovascular rotation, which allows for greater exposure and the acceleration of skills that may not have been fully developed during General Surgery residency. While endovascular and hybrid cases are inherent to every rotation, this time is dedicated to imaging techniques, interpretation of advanced imaging, radiation safety, basic and complex endovascular techniques and devices. This is a separate yet complementary rotation with emphasis on building on fundamental techniques to more sophisticated applications of minimally invasive technology. Simulation exercises and wet labs are also an integral part of the training program. These sessions are performed in conjunction with the institution’s simulation center as well as major vendors with simulation packages and programs. A separate wet lab and fundamental techniques sessions are held several times in the year.
The Vascular Surgery Fellowship is comprised of three fellows per year who work in conjunction with the Vascular Surgery residents. This integration permits opportunities for the fellows to work with, teach and mentor junior Vascular Surgery residents, in addition to General Surgery residents who rotate on the Vascular Surgery services. The large number of trainees assures collegiality, camaraderie and adherence to the work-hour regulations. Weekly conferences, didactic sessions, simulation and wet lab exposure, as well as Monthly Journal Club take place both on and off campus. Each of the two-year training programs permits travel to two national vascular meetings as well as many opportunities for onsite training in all major aortic stent devices and peripheral platforms.
Case volumes are above the national average for vascular training. Fellows will log cases on a weekly basis on the ACGME website for compliance and recording. The fellowship provides ample case volume for both endovascular and open cases exceeding the national requirements for many areas.
They meet the required number of vascular cases between the fourth and fifth years. On average, they complete more than 200 general surgery cases with 20 percent of these being laparoscopic.
Our 0+5 Integrated Vascular Surgery Residency Program started in 2009 and by August 2010 expanded to allow two accredited residents per year. The program is designed to provide graduated, incremental training. The training focuses on vascular surgery, vascular research, general surgery, cardiothoracic surgery and core rotations. Endovascular rotations are scattered throughout the five years to provide dedicated time and enhanced exposure.
The first two years are geared toward developing a foundation in patient care and technical skills. Four months are spent on vascular surgery each year. General surgery rotations included colorectal, transplant, acute care surgery, pediatrics and trauma. Additional core rotations include vascular medicine, stroke, ICU and cardiology. These rotations provide a diverse group of patient care issues as well as exposure to open surgical skills.
The third year is a transition year aimed at further developing surgical skills and decision making. In this year, many rotations in both general and vascular surgery place residents in the position of “Chief of Service.” This provides an opportunity to develop leaders as well as teachers of junior residents and students.
By the fourth year, the focus shifts toward vascular surgery training with residents completing six months in advanced surgery rotations, including trauma and cardiothoracic surgery. The remaining six months and all of the fifth year is dedicated to vascular surgery. In both the fourth and fifth years, residents on vascular services are expected to run their own service separate from fellows. The various vascular surgery rotations have dedicated objectives within vascular surgery, including peripheral occlusive disease, access, cerebrovascular, complex aortic and decision making skills.
Residents also participate in simulation-based training. This is designed to provide residents with basic surgical techniques and fundamentals unique to vascular surgery. Hands-on models with senior trainees and staff supervision gives residents focused learning outside of the rigors of the operating room. This curriculum has been developed based on resident feedback from the last five years. Each rotation is carefully chosen and geared toward an optimal educational experience at each level, with a focus on progressive learning, complexity and responsibility.
Our current senior residents have performed approximately 41 percent of the defined vascular cases as open and 56 percent as endovascular.
The vascular surgery training program offers a variety of experiences to optimize education, skills and research.
Vascular Lab Experience »
The Vascular Laboratory is run concomitantly with Vascular Medicine and Vascular Surgery. Trainees have dedicated time to learn about the performance and interpretation of vascular laboratory studies. Our trainees who successfully meet the qualifications can obtain their Registered Physician in Vascular Interpretation (RPVI) prior to matriculating from our programs.
Each trainee, upon entrance to one of our programs, is assigned a faculty mentor. This mentor will facilitate the trainee’s integration into Cleveland Clinic and assist him or her throughout their time here. Many mentor and trainees develop research collaborations and discuss career goals, job placements and personal issues.
Multiple educational conferences occur on a weekly or monthly, basis that helps to supplement the clinical training within our programs. These include:
- Chairman’s Conference
- Morbidity and Mortality Conference
- Aortic Conference (multidisciplinary, monthly)
- Carotid Conference (multidisciplinary, monthly)
- Didactic Conference
- Career Development Conference (monthly)
- Journal Club (monthly)
Fellows and residents have the opportunity to attend national meetings during their training. Typically, first-year fellows and fourth-year residents attend the Society for Clinical Vascular Surgery and the Venous Course, while second-year fellows and fifth-year residents opt to attend the Annual UCLA Symposium and the VEITH meeting. In addition, the trainee scoring the highest percentile on the ABSITE examination and VSITE examination can attend a meeting of his or her choice. Furthermore, the department supports attendance of meetings at which a resident or fellow is doing a podium presentation for their research.
In both training programs, residents and fellows have the opportunity to participate in administrative roles. An administrative Chief Resident and Chief Fellow are elected by their peers to assist in the day-to-day administration of activities of their program. In addition, a resident and fellow serve as Quality Officers taking responsibility for organizing the Morbidity and Mortality Conference and organizing their program’s Quality Improvement Project. Lastly, residents and fellows have the opportunity to hold membership in the department’s Education Committee.
Cleveland Clinic's Department of Vascular Surgery and Office of Graduate Medical Education work diligently to ensure that residents and fellows are compliant with specific work-hour restrictions applicable to their level of training. Our goal is for zero-tolerance of work-hour violations.
Over the past five years, all of our graduates have successfully passed the Vascular Qualifying Exam on their first attempt. In addition, 86 percent have successfully completed the Vascular Certifying Exam on the first attempt, with all passing by the second. Our Integrated Training Program will be graduating its first trainee this year, and thus no data on board performance is available for that group. Given the size of our programs, we attract a number of applicants with varied interests. This is represented in the career paths of our graduates. Nearly half of our graduates pursue careers in traditional academic centers, with the others entering private practice or fulfilling military obligations. Many have gone on to become successful leaders within their organizations.
Graduate Medical Education»
The Graduate Medical Education (GME) Department is committed to ensuring that Cleveland Clinic training programs meet and exceed national and institutional standards. In addition to providing support to the GME Committee, the staff of the GME Department is responsible for providing quality services to all applicants, trainees and program directors.
The Graduate Medical Education Council of Cleveland Clinic functions as an agent of the Education Governing Group. It monitors, advises and develops policies for graduate medical education to ensure maintenance of high quality programs. The council continuously monitors the medical educational environment and assists with program enhancements and challenges as they arise.
Cleveland Clinic Lerner College of Medicine – CWRU»
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University was established in 2002 and represents a partnership between Cleveland Clinic and Case Western Reserve University. It is focused on educating a limited number of highly qualified persons who seek to become physician investigators and scientists committed to the advancement of biomedical research and clinical practice. Medical students from the college participate in surgical rotations with the Department of Vascular Surgery, and interact frequently with trainees in the Vascular Surgery Training Programs.
Vascular Surgery Fellowship & Residency Applications
For a Vascular Surgery Fellowship application, go to:
ERAS®, the Electronic Residency Application Service at The Association of American Medical Colleges
The application process begins Dec. 1 and extends through Feb. 1.
For a Vascular Surgery Residency application, visit:
ERAS® - the Electronic Residency Application Service
The application process begins Sept. 1.
Specific information regarding either the Vascular Surgery Fellowship or Residency program may be obtained by contacting:
Local 216.444.4311 or toll-free 800.223.2273 ext. 44311
Elective Rotation Applications
Medical students and residents interested in submitting an application to the Department of Vascular Surgery for an elective rotation may contact the Division of Education (Graduate Medical Education at 216.444.5690) or go to the Graduate Medical Education website and follow the instructions under the application process.